Brockes Christiane, Rahn-Schönbeck Mariette, Duru Firat, Candinas Reto, Turina Marko
Cardiovascular Surgery, Cardiovascular Center, University Hospital, Zurich, Switzerland.
J Interv Card Electrophysiol. 2003 Feb;8(1):45-8. doi: 10.1023/a:1022391931093.
Automatic capture verification using the Autocapture (AC) feature enabled by paced evoked response detection and delivery of high energy back-up pulses intends to increase patient safety. Furthermore, adjustment of stimulation outputs can save energy and potentially improve pacemaker (PM) longevity. The purpose of this study was to evaluate the theoretical longevity of a new dual chamber PM with the integrated AC feature (Affinity DR, St. Jude Medical) in comparison to the longevity of a previous model from the same manufacturer without AC (Trilogy DR).
Affinity PMs were implanted in 16 patients and connected to a compatible lead with low polarization properties. AC was activated when the evoked response was significantly higher than the polarization voltage. Theoretical PM longevity was calculated with and without AC during follow-up. The measured and calculated values were compared to measurements in 19 patients, who consecutively received Trilogy-PMs during the same time period.
In only one patient the evoked response was not adequate, and as a result, AC was not programmed. The calculated longevity of the Affinity-PMs 79 +/- 28 days after implantation was significantly higher in comparison to the Trilogy-PMs (Affinity-PMs: 8.9 +/- 1.2 years without and 9.5 +/- 1.1 years with AC; Trilogy-PMs: 6.5 +/- 0.8 years) (p < 0.005).
The AC feature is an optional algorithm that can be activated in most patients and it significantly prolongs predicted battery longevity due to automatic adjustment of stimulation outputs.
通过起搏诱发反应检测启用自动捕获（AC）功能并输送高能量备用脉冲进行自动捕获验证，旨在提高患者安全性。此外，调整刺激输出可节省能量并可能延长起搏器（PM）寿命。本研究的目的是评估具有集成AC功能的新型双腔PM（圣犹达医疗公司的Affinity DR）与同一制造商之前无AC功能的型号（Trilogy DR）相比的理论寿命。
16例患者植入了Affinity PM，并连接到具有低极化特性的兼容导线。当诱发反应明显高于极化电压时激活AC。随访期间计算有和无AC时的理论PM寿命。将测量值和计算值与同期连续接受Trilogy-PM的19例患者的测量值进行比较。
仅1例患者的诱发反应不充分，因此未设置AC。植入后79±28天，Affinity-PM的计算寿命明显高于Trilogy-PM（Affinity-PM：无AC时为8.9±1.2年，有AC时为9.5±1.1年；Trilogy-PM：6.5±0.8年）（p<0.005）。
AC功能是一种可选算法，大多数患者均可激活，由于刺激输出的自动调整，它可显著延长预测的电池寿命。
